The health impact of alcohol tax reduction : an implication to Hong Kong

Abstract

Introduction: Alcohol is a major contributor to pre-mature deaths globally, being ranked as the world's third greatest risk factor of deaths and disability and among the middle and high income countries the most important one. Recent meta-analyses have concluded that increasing alcohol tax is an effective mean to curb the alcohol epidemic by lowering alcohol consumption as the mediator. However, the Hong Kong Special Administrative Region (SAR) abolished the duty rate of all alcohol with strength less than 30% by volume effective from 27 February 2008. In this study, I reviewed the literature to assess and address the issues relating to the health impact of this policy change.

Objectives: To evaluate the health impact of alcohol tax reduction in other regions based on published research reports and assess the generalizability of the findings to Hong Kong local setting

Methods: Published studies on health impact of alcohol tax or price reduction were identified by PubMed. Inclusion criteria were: 1. all studies on alcohol tax reduction in any regions or countries; 2. in the studies outcome measures or any health impact of the alcohol tax reduction were clear and measurable; 3. original studies. On the other hand, editorial or legal reviews, commentaries, letters or articles with no component of epidemiological study and duplicated studies of the same data set were excluded. Non-English literature and non-human studies were excluded as well. There were totally 15 articles fulfilling all the criteria for final review.

Results: There were diverging effects in the change of alcohol consumption after the alcohol tax reduction and the liberalization of the travellers’ import among Nordic regional countries and Switzerland. However, the studies consistently showed an increase of alcohol-related mortality and hospitalization among different subgroups, for instance, the older or younger age group and the worst or better off population including the more frequent and heavy drinkers. No effect on other alcohol related harms such as interpersonal violence, traumatic brain injuries or crimes were found in association with the policy changes.

Discussion: Policy makers should cautiously weigh the apparent economic benefit of alcohol tax reduction against the cost of public health damage. Drinking small amount of alcohol especially wine is still regarded as something good for health among the general public in Hong Kong. With the alcohol taxation abolished, it is likely the drinking culture, among the younger people will be incubated. Raising the public awareness of the harmful effect from alcohol drinking among Chinese population should be set as a top priority. A comprehensive surveillance on alcohol consumption and its related harm is urgently needed. Additionally, further evidence-based studies are warranted in order to investigate the health impact from the abolition of alcohol tax in Hong Kong.